open access

Vol 60, No 6 (2009)
Case report
Published online: 2009-12-30
Submitted: 2013-02-15
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The difficulties in differential diagnosis of primary aldosteronism subtypes in women with strokes at a young age

Anna Bohdanowicz-Pawlak, Jadwiga Szymczak, Joanna Jakubowska, Anna Brona
Endokrynologia Polska 2009;60(6):492-496.

open access

Vol 60, No 6 (2009)
Case report
Published online: 2009-12-30
Submitted: 2013-02-15

Abstract

In patients with primary aldosteronism (PA), it is fundamental to distinguish between subtypes that benefit from different treatment. The authors describe difficulties in differential diagnosis in a case of 46 year old women with PA and two strokes in the past. Based on high plasma and urine aldosterone concentration, low plasma renin activity (PRA), very high aldosterone/PRA ratio and unilateral macroadenoma detected in computed tomography, aldosterone producing adenoma was diagnosed and the patient was performed unilateral adrenalectomy. Despite the surgical treatment the patient still presented with clinical and biochemical PA symptoms. Moreover, histological examination suggested adrenal hyperplasia, and laboratory tests were typical for glucocorticoid-remediable aldosteronism. Unfortunately, we didn’t find a chimeric CYP 11β1/CYP 11β2 gene. Finally, bilateral adrenal hyperplasia was diagnosed and medical treatment with aldosterone antagonist was initiated.

Abstract

In patients with primary aldosteronism (PA), it is fundamental to distinguish between subtypes that benefit from different treatment. The authors describe difficulties in differential diagnosis in a case of 46 year old women with PA and two strokes in the past. Based on high plasma and urine aldosterone concentration, low plasma renin activity (PRA), very high aldosterone/PRA ratio and unilateral macroadenoma detected in computed tomography, aldosterone producing adenoma was diagnosed and the patient was performed unilateral adrenalectomy. Despite the surgical treatment the patient still presented with clinical and biochemical PA symptoms. Moreover, histological examination suggested adrenal hyperplasia, and laboratory tests were typical for glucocorticoid-remediable aldosteronism. Unfortunately, we didn’t find a chimeric CYP 11β1/CYP 11β2 gene. Finally, bilateral adrenal hyperplasia was diagnosed and medical treatment with aldosterone antagonist was initiated.
Get Citation

Keywords

primary aldosteronism; aldosterone producing adenoma; bilateral adrenal hyperplasia; glucocorticoid-remediable aldosteronism

About this article
Title

The difficulties in differential diagnosis of primary aldosteronism subtypes in women with strokes at a young age

Journal

Endokrynologia Polska

Issue

Vol 60, No 6 (2009)

Pages

492-496

Published online

2009-12-30

Bibliographic record

Endokrynologia Polska 2009;60(6):492-496.

Keywords

primary aldosteronism
aldosterone producing adenoma
bilateral adrenal hyperplasia
glucocorticoid-remediable aldosteronism

Authors

Anna Bohdanowicz-Pawlak
Jadwiga Szymczak
Joanna Jakubowska
Anna Brona

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